"Cleaning" the Uterus
A dilatation and curettage (also called 'dilation and curettage' or, in the vernacular, a 'D&C') is a minor diagnostic surgery performed to clear out tissue from the uterus. It is often recommended in cases where a woman is experiencing abnormal bleeding, fibroids, or adhesions, and may be done under emergency circumstances in the case of a miscarriage.
The main purpose behind a D&C is to remove excess tissue from the interior of the uterus. If this tissue were to be left alone, it could cause severe reproductive complications, possibly leading to sepsis and even death. In most cases, D&C is beneficial as it reduces the painful and uncomfortable effects of endometriosis or abnormal menstrual periods, and can be used to diagnose additional intrauterine abnormalities before they begin to cause the patient difficulty. There is a slim chance that a D&C will result in injury or infection to the reproductive system, and for this reason, its applications are strictly limited.
D&C is used as an investigative surgery for infertile women, to check the ovulatory process and exclude the presence of tuberculous endometritis. In this case, however, some doctors feel other methods would be better suited to the task.
Methods of Checking Ovulation
While a D&C is undoubtedly a thorough investigation of the uterus and connecting tissues, it does pose risks to the patient. Uterine perforation, infection of the uterus or fallopian tubes, and a possible increase in intrauterine adhesions can all result from the performance of a D&C. Studies show that women who have had multiple D&Cs are at an elevated risk for these outcomes. This is enough for most doctors to limit D&C performance only to cases where it is absolutely necessary.
In the case of infertile women, modern medical science has developed a way of monitoring ovulation without the need for an investigative D&C. A home ovulation test can easily and conveniently supply information about a woman's ovulation to her doctor without repeated visits or surgery.
Using a Home Ovulation Test
An ovulation test works in a similar manner to a pregnancy test, in that it tests the urine for hormones. However, while a pregnancy test detected levels of human Chorionic Gonadotropin, an ovulation test looks for traces of luteinizing hormone (LH). Luteinizing hormone triggers the release of the egg from the ovaries, and spikes just hours prior to ovulation. Positive results on an ovulation test indicate a woman will be fertile for the next forty-eight hours, and can help infertile or subfertile couples time their intercourse to maximize their chances of success.
There are two types of ovulation test available on the market: a seven-day daily ovulation test, which provides notice of the two most fertile days during one week, and a twenty-day daily ovulation test, which gives a broader picture of the woman's menstrual cycle. Women with regular periods may save some money and time by using the seven-day ovulation test, while women who are just starting out in their attempts to conceive might find the twenty-day ovulation test both useful and educational.
For infertile women, being notified of their most fertile days in the comfort of their own home is well worth the cost of an ovulation test. It saves on effort, time, and worry. An ovulation test can also be used as a barometer of reproductive health; if you've been using an ovulation test for over twenty-eight days without a positive result, continue for a second month and consult your doctor if results are still negative. In this way an ovulation test can provide the first glimpse of a possibly serious reproductive problem.
If your doctor suggests a D&C to investigate for any ovulatory problems, ask to try the home ovulation test method first. It could save you a great deal of difficulty later on, and who knows - it might have a positive effect on your fertility!
